BACKGROUND: The simultaneous occurrence of cardiovascular disease (CVD), kidney disease, and anaemia is associated with increased morbidity and mortality. In the community setting, little data exists about the risk associated with milder levels of anaemia when it is present concurrently with CVD and chronic kidney disease (CKD). The aim of this study was to establish the prevalence of CKD and anaemia in patients with CVD in the community and to examine whether the presence of anaemia was associated with increased morbidity and mortality. METHODS: This study was designed as a retrospective cohort study and involved a random sample of 35 general practices in the West of Ireland. A practice-based sample of 1,609 patients with established cardiovascular disease was generated in 2000/2001 and followed for five years. The primary endpoint was death from any cause. Statistical analysis involved using one-way ANOVA and Chi-squared tests for baseline data and Cox proportional-hazards models for mortality data. RESULTS: Of the study sample of 617 patients with blood results, 33% (n = 203) had CKD while 6% (n = 37) had CKD and anaemia. The estimated risk of death from any cause, when compared to patients with cardiovascular disease only, was almost double (HR = 1.98, 95% CI 0.99 to 3.98) for patients with both CVD and CKD and was over 4 times greater (HR = 4.33, 95% CI 1.76 to 10.68) for patients with CVD, CKD and anaemia. CONCLUSION: In patients with cardiovascular disease in the community, chronic kidney disease and anaemia occur commonly. The presence of chronic kidney disease carries an increased mortality risk which increases in an additive way with the addition of anaemia. These results suggest that early primary care diagnosis and management of this high risk group may be worthwhile.

The impact of renal insufficiency and anaemia on survival in patients with cardiovascular disease: a cohort study. 2009, 9:51 BMC Cardiovasc Disord

en

dc.identifier.issn

1471-2261

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dc.identifier.pmid

19909540

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dc.identifier.doi

10.1186/1471-2261-9-51

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dc.identifier.uri

http://hdl.handle.net/10147/93843

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dc.description.abstract

BACKGROUND: The simultaneous occurrence of cardiovascular disease (CVD), kidney disease, and anaemia is associated with increased morbidity and mortality. In the community setting, little data exists about the risk associated with milder levels of anaemia when it is present concurrently with CVD and chronic kidney disease (CKD). The aim of this study was to establish the prevalence of CKD and anaemia in patients with CVD in the community and to examine whether the presence of anaemia was associated with increased morbidity and mortality. METHODS: This study was designed as a retrospective cohort study and involved a random sample of 35 general practices in the West of Ireland. A practice-based sample of 1,609 patients with established cardiovascular disease was generated in 2000/2001 and followed for five years. The primary endpoint was death from any cause. Statistical analysis involved using one-way ANOVA and Chi-squared tests for baseline data and Cox proportional-hazards models for mortality data. RESULTS: Of the study sample of 617 patients with blood results, 33% (n = 203) had CKD while 6% (n = 37) had CKD and anaemia. The estimated risk of death from any cause, when compared to patients with cardiovascular disease only, was almost double (HR = 1.98, 95% CI 0.99 to 3.98) for patients with both CVD and CKD and was over 4 times greater (HR = 4.33, 95% CI 1.76 to 10.68) for patients with CVD, CKD and anaemia. CONCLUSION: In patients with cardiovascular disease in the community, chronic kidney disease and anaemia occur commonly. The presence of chronic kidney disease carries an increased mortality risk which increases in an additive way with the addition of anaemia. These results suggest that early primary care diagnosis and management of this high risk group may be worthwhile.

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dc.language.iso

en

en

dc.subject.mesh

Aged

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dc.subject.mesh

Anemia

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dc.subject.mesh

Cardiovascular Diseases

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dc.subject.mesh

Cause of Death

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dc.subject.mesh

Chi-Square Distribution

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dc.subject.mesh

Cohort Studies

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dc.subject.mesh

Comorbidity

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dc.subject.mesh

Female

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dc.subject.mesh

Humans

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dc.subject.mesh

Ireland

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dc.subject.mesh

Kaplan-Meiers Estimate

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dc.subject.mesh

Male

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dc.subject.mesh

Middle Aged

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dc.subject.mesh

Prevalence

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dc.subject.mesh

Proportional Hazards Models

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dc.subject.mesh

Renal Insufficiency, Chronic

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dc.subject.mesh

Retrospective Studies

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dc.subject.mesh

Risk Assessment

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dc.subject.mesh

Risk Factors

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dc.subject.mesh

Time Factors

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dc.title

The impact of renal insufficiency and anaemia on survival in patients with cardiovascular disease: a cohort study.